中药灌肠联合西药治疗急性重症胰腺炎临床研究

目的:观察中药灌肠联合西药治疗急性重症胰腺炎的临床疗效。方法:选取2014年8月—2015年8月期间收治的急性重症胰腺炎患者84例作为研究对象,随机分为对照组与研究组,各42例。对照组采用常规西药进行治疗,研究组在对照组基础上联合中药灌肠治疗,观察两组患者临床指标改善情况、淀粉酶变化情况、临床症状缓解时间以及不良反应情况,评价临床疗效。结果:研究组、对照组治疗有效率分别为92.86%、80.95%,两组比较,差异有统计学意义(P0.05)。治疗后研究组患者白细胞、肌酐、血糖、血尿素氮、淀粉酶以及急性生理与慢性健康(acute physiology and chronic health evaluation,APACHE-Ⅱ)评分水平明显低于对照组,差异有统计学意义(P0.05)。治疗前、治疗后24 h两组患者淀粉酶水平比较,差异无统计学意义(P0.05);治疗48 h、72 h后研究组淀粉酶水平明显低于对照组,差异有统计学意义(P0.05)。研究组患者腹痛缓解时间、体温恢复时间、自主通便时间、住院时间均短于对照组,两组比较,差异有统计学意义(P0.05)。研究组不良反应发生率为9.52%,对照组不良反应发生率为11.90%,两组比较,差异无统计学意义(P0.05)。结论:中药灌肠配合西药治疗急性重症胰腺炎效果较好,可明显改善各项临床指标,降低淀粉酶水平,不良反应少,安全性较高。

Clinical Study of TCM Enema Combined with Western Medicine in Treatment of Severe Acute Pancreatitis

Objective:To study the clinical effect of TCM enema combined with western medicine in treatment of severe acute pancreatitis.Methods:84 cases of severe acute pancreatitis treated in our hospital from August 2014 to August 2015 were randomly divided into two groups,with 42 cases in each each.42 patients were treated with conventional western medicine as the control group,and the other 42 patients treatcd with TCM enema as the study group.The treatment effect,clinical index improvement,amylase change,clinical symptoms,remission time and adverse reactions of the two groups were observed.Results:The total effective rate of the study group and the control group was 92.86％ and 90.48％ respectively,and the difference of the total effective rate between the two groups was statistically significant (P ＜ 0.05).Before treatment the WBC,Cr,GLU,BUN,amylase and APACHEⅡ score levels of both groups of patients showed no significant difference (P ＞ 0.05),while after treatment the Cr,GLU of group WBC,BUN,amylase and APACHE-score was significantly lower than those of the control group respectively,with the difference being statistically significant (P ＜ 0.05).Before treatment,the difference of 24 h amylase levels between the two groups of patients was not statistically significant (P ＞ 0.05),while after the treatment of 48h and 72h the amylase levels of the study group were significantly lower than those of the control group,with the difference being statistically significant (P ＜ 0.05).The relief of abdominal pain,body temperature,autonomic ventilation and hospitalization time of the study group were better than those of the control group,with the difference being statistically significant (P ＜ 0.05).The adverse reactions include nausea,abdominal pain and hematochezia of the study group and the control group was 9.52％ and 11.90％ respectively and there was no significant difference between the two groups (P ＞ 0.05).Conclusion:Traditional Chinese medicine enema in treatment of severe acute pancreatitis combined with of Western medicine can achieve better clinical effect,improve the clinical indicators,reduce the amylase levels,improve patients' health level,help the clinical symptoms disappear sooner,with less adverse reaction and high safety.